Worldwide, 1 in every 5 adults suffers from chronic pain (Breivik, Hattori & Moulin 2005). In the United States, the number is even higher. A recent survey found that more than half of Americans live with chronic or recurring pain that interferes with their mood, sleep, ability to work and enjoyment of life (ABC News 2005). The National Institutes of Health (NIH), citing pain as the number-one reason Americans seek medical care, estimates that the annual total cost of pain in the U.S. is more than $100 billion in health care and lost productivity (NIH 2003). To address this growing problem, Congress officially declared 2000–2010 the “Decade of Pain Control and Research.” Halfway through this 10-year period, yoga has emerged as a powerful tool to help relieve the suffering associated with chronic pain.

Understanding Chronic Pain

Chronic pain triggers vary broadly and include traumatic injury, autoimmune disorders and musculoskeletal problems. Whatever the initial cause, all chronic pain shares a common effect: the frustration it causes to both sufferers and healthcare providers. By its very definition, chronic pain—pain that lasts 3 months or longer—has not been successfully managed through medical treatment or self-care. Individuals with chronic pain have typically tried—and found little relief from—an exhausting number of remedies, including over-the-counter and prescription medications, massage, chiropractic care and physical therapy.

Yoga Research Reiew

Because chronic pain is a mind-body phenomenon, many researchers and chronic-pain sufferers are turning to yoga for pain relief. Yoga integrates physical movement, which can play an important role in pain recovery, with mindful practices that address the cognitive and emotional components of pain. Studies show that yoga can reduce not only the experience of pain itself but also the emotional distress and physical disability associated with it, as well as the use of pain medication (Kolasinski et al. 2005; Garfinkel et al. 1998; Gaur et al. 2001). Two recent clinical trials demonstrated the benefits of yoga for back pain, the most commonly experienced form of pain among adults in the U.S. (ABC News 2005).

Building Self-Efficacy

Research suggests that self-efficacy, the belief that you can cope with the stress and challenges of a specific situation, is an important part of recovering from, or adjusting to, chronic pain (Turner, Ersek & Kemp 2005). Greater self-efficacy is associated with less pain-related disability and depression, even when controlling for pain intensity. Self-efficacy also predicts individuals’ willingness to use physical exercise and stretching as a way to manage pain.

Dealing with Fear of Activity

Chronic pain and fear of pain can become part of a vicious cycle: Fear leads to avoiding any activity that might trigger pain, and inactivity leads to greater physical disability and pain (Boersma & Linton 2005). Research shows that breaking this cycle, and being willing to engage in activity, is an important predictor of improvements in both physical function and emotional suffering (McCracken & Eccleston 2005).

Teaching Mindfuness

In yoga, mindfulness is the ability to notice sensation, to focus attention on the present moment and to move with conscious intention. This turns out to be incredibly important for individuals with chronic pain, as they learn to face their fear of activity and develop new ways of being present in their bodies. Along with avoidance, many individuals have learned to rely on distraction as a coping strategy. Distraction makes it possible to ignore pain and perform an activity in the short term. However, people who use distraction as a coping strategy during activity experience more pain afterward than those who stay mentally engaged (Goubert et al. 2004).

Core Lessons

Chronic pain is a complex and frustrating phenomenon. The good news is that effective yoga for chronic pain classes do not need to be either complicated or overwhelming. Research and experience suggest that the most beneficial interventions distill the practice of yoga to its core lessons: how to breathe; how to take care of yourself through conscious movement and a balance of rest and activity; and how to make peace with the present moment. These, of course, are useful lessons for all of us—not just those in chronic pain. But for those in pain, the lessons of yoga may mean the difference between the usual moment of suffering and the much-sought-after moment of ease in mind and body.

For those who want to seriously practice kriyas, it is time to
formulate a specific sadhana. Sadhana means "endeavoring to obtain a
particular result." The result kriyabans seek is accelerated spiritual
evolution. Sadhana becomes a powerful method to achieve this result.
There are three important aspects of sadhana: choice, commitment and
aspiration.
The first stage of sadhana is to choose a practice. Even the most
simple sadhana will be challenging to the newcomer. Consider the
sadhana of lighting a candle every night, then immediately blowing it
out. Nothing more or nothing less. Do this for ninety days. You will
observe the mind coming up with every reason why you shouldn't do it
and every excuse why you missed a few (or many) nights. Yet by
accepting it as a sadhana, you make a choice to do it and it becomes a
spiritual practice.
The second aspect of sadhana relates to regularity -- doing
something at periodic intervals. This typically would be at the same
time in the same place everyday. Yet it doesn't have to be everyday;
it could be every other day or every Tuesday and Thursday, as long as
it is regular. Doing practice irregularly is not sadhana. Once the
schedule is selected, the challenge of sadhana is to stick with it --
not to miss the appointed time. This is the first measure of
commitment. The second measure is to make a commitment for a specific
period of time; that is, choose do the practice for thirty days, sixty
days, ninety days, or even 108 days. Notice the level of your success,
then take a break. Decide upon another practice (or the same one) and
make another commitment.
Yet choice and regularity are not the only aspects of sadhana. If
they were, simply dressing every day would be a sadhana. We choose
what clothes to wear and we do it. Dressing could be a sadhana, yet
it is just a mechanical action done every day. Thus, the final key to
a successful sadhana is conscious intention. This is where the power
is generated, and more still, when the intention becomes an
aspiration.
Consider once again the candle exercise cited above. Initially, it
will challenge the mind and the ego. The spiritual "you" may even win
the battle, but to keep it from becoming mechanical, an intention is
required. Try this variation. Light the candle. Say, "This is all I
have to do for the benefit of self, other, and the world." Then blow
out the candle. Doing no other practice than this will begin a
transformation process that will alter your life. To add even more
power behind it, consider this statement, "This is all I have to do to
remember who I am; I remember this for the benefit of Self, Other,
and the World."
One immediate result of sadhana is the remembrance of "who we are"
rather than "what we are" during the brief moments the sadhana takes.
Repetitively remembering our inner essence nature is at the heart of
all spiritual growth. One day we will remember our spiritual essence
in every moment. That is the realized state.
So start with a simple sadhana to build your confidence. Add
another sadhana in addition to this one. Expand a sadhana to include
many practices including yoga or other bodily movement, chanting or
inner mantra, and kriya practice.
Copyright 1994, Alan Verdegraal, "Tantra: The Magazine", P.O.Box 108,
Torreon, NM 87061, Issue #8, p22-23.
Excerpt from Sadhana at sacred-texts.com

HIRANYAGARBHA. [Source: Dowson’s Classical Dictionary of Hindu Mythology] ‘Golden egg’ or ‘golden womb.’ In the Rigveda Hiranyagarbha “is said to have arisen in the beginning, the one lord of all beings, who upholds heaven and earth, who gives life and breath, whose command even the gods obey, who is the god over all gods, and the one animating principle of their being.” According to Manu, Hiranyagarbha was Brahma, the first male, formed by the indiscernible eternal First Cause in a golden egg resplendent as the sun. “Having continued a year in the egg, Brahma divided it into two parts by his mere thought, and with these two shells he formed the heavens and the earth; and in the middle he placed the sky, the eight regions, and the eternal abode of the waters.”

Greatness in any skill comes after a lot of practice, and that practice has to start somewhere. A few weeks ago, I had a text exchange with a yoga teacher who was at that starting point.

She was about to teach her first fully-booked class and, although she was a stellar student in her teacher training, she felt terrified enough to half-jokingly ask me, 10 minutes before class time, if I could teach in her place. I did not. Instead, I stopped thinking about anything else for a moment so I could quickly tell her what I thought would help her the most in that moment. A simple “Oh, you’ll do fine” wouldn’t have worked.

It turns out that the class went well and was followed with very positive feedback from the students. Here is a more detailed version of what I told her.

1. Remember why you teach.

How do you finish the sentence, “I teach yoga because…”?

Each teacher’s motivation to teach is unique, but they likely all have one element in common: a desire to share the benefits of the practice with others. After graduating a teacher training, beginning teachers tend to have so much information swimming around in their heads that they lose sight of the original reason they started to teach. Taking a moment to remember that you love yoga and that you chose to endeavor to share it works wonders for calming nerves and focusing instruction.

2. Remember what yoga is.

What is it that makes what you are teaching a yoga practice? It’s important for teachers of all experience levels to know the answer to this, though not enough of them seem to even ask themselves the question. Right now, at the starting point of your teaching career, develop the habit of reminding yourself of your answer to this whenever you need to clarify what you are teaching others to do on their yoga mats.

3. Teach what you know.

In every training, I am asked whether it’s okay to teach things you can’t do yourself. The answer is yes and no. If it’s something you can’t do because you have a broken leg, then, yes, it’s okay, assuming you were able to do it before whatever broke your leg happened. Otherwise, no.

When I’m asked this, I reply with a question, “Why would you want to teach something you don’t know?” There is such pressure on all of us, yoga teachers or not, to get to the next thing. That mentality is helpful in an area where innovation is desired. But, in yoga practice, the work is meant to point our minds to the perfect present, not to the nonexistent future. Use your practice and teaching as time to let go of needing to move on.

Teaching yoga asana to people with different body structures and skill levels requires not only knowing how the pose works in your own body, but also knowing how it works in all the other kinds of bodies in the class. If you teach a pose that you aspire to, or that you’ve just done a few times, it won’t happen.

And, while there are many things you aren’t ready to teach, the flip side is that there are many things that you know very well, and that your students don’t yet know. Teach them those things.

4. Be prepared.

Great teachers constantly adapt their teaching strategy to the students who are present. Managing such adaptation becomes second nature after years of experience, but that doesn’t help the new teacher a lot. So, I teach them to prepare each of their classes in an intelligent way, with a specific process of sequencing, then to be ready to throw out the prep as they see what actually presents itself in class.

Why draft something that you’re not going to use? Because the more you work out plans in the low-stress times when you’re not teaching, the better you are at calmly making the right choices when you’re guiding the practices of others.

5. Remember that you are teaching people.

While some teachers take on a theatrical tone when teaching, as if playing the role of a yoga teacher, the great ones communicate in a way that seems effortless and unadorned.

Every budding teacher I’ve trained thus far has been able to talk to me, one on one, clearly and effectively. Applying that same skill to a group is not so hard when you remind yourself that you are talking to people. Alternatively, teachers see their students as poses, or as tests of their knowledge or teaching ability. While it’s true that we do teach poses and that we sometimes do that better than at other times, we are always teaching those things to human beings.

Consider something that you know very well, like how to brush your teeth. It would probably be very easy for you to teach that to somebody, and you would probably speak to them in the same way as if you weren’t teaching them. There is no reason to speak any differently.

Look your students in their eyes and talk them through their yoga practice. Assuming you know what you are teaching, this strategy opens up communication in familiar territory, which helps you teach effectively in your own voice.

6. Watch your students.

Every asana has at least a few dozen points about position and effort. Common weaknesses with beginning teachers are that they say too many of these points, not enough of them, or that they say the ones that aren’t needed.

One way to give the perfect amount of instruction is to watch your students. See what they need to hear, and wait to be sure they got the last instruction before you go on to the next one. This prevents wasted time and energy, and it makes each instruction more potent. It is also a manifestation of a fundamental instruction for yoga practice, the first of Patanjali’s yoga sutras: “Yoga is now.”

7. It’s not about you.

Before I was a yoga teacher, I did a little performance work that grew popular enough for me to be scared stiff before some shows. Once, as I was gripped with fear, a friend reminded me that the audience had come to have a good time and that they were there because they thought I’d help make that happen. And then I wasn’t scared.

Remind yourself of the same thing as a yoga teacher. People are coming to yoga class to get to a better place somehow, and they’ve chosen your class because they think you might help do that. They want you to succeed. They aren’t coming to class to critique you. In fact, they’re probably seeking your approval much more than they’re deciding whether you get theirs. Make your instruction more about them than it is about you. You chose to teach so that they could practice. Speak the words that allow that to happen without fear of criticism.